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<title>View Q3</title>
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	<table border="0" width="800" id="table1" cellspacing="0" cellpadding="0">
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			<td height="30">
			<p align="center">
			<font face="Verdana" style="font-size: 10pt; font-weight: 700" color="#000000">
			Questionnaire No. 3</font></td>
		</tr>
		<tr>
			<td height="19">
			<p align="center">
			<font face="Arial" style="font-size: 8.5pt" color="#000000">For 
			Field Survey (Village Level questionnaire)</font></td>
		</tr>
		<tr>
			<td height="18">
			<p align="center">
			<font style="font-size: 8.5pt" face="Arial" color="#000000">Page 8</font></td>
		</tr>
		<tr>
			<td><span style="font-weight: 700">
			<font face="Arial" style="font-size: 8.5pt" color="#000000">&nbsp;Form Id = <?php echo $frm?>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;District Name = <?php echo $dis_name?></font></span></td>
		</tr>
		<tr><td>&nbsp;</td></tr>
		<tr>
			<td bgcolor="#EEEEEE" height="20"><font color="#000000">&nbsp;
			<span style="font-weight: 700">
			<font face="Arial" style="font-size: 8.5pt">Risk Assessment &amp; 
			Analysis (For Each hand pump / Open well / Tube well / GLR / P &amp; T 
			systems) </font></span></font></td>
		</tr>
		<tr>
			<td>
			&nbsp;<font face="Verdana" style="font-size: 8.5pt" color="#000000">Source 
			of Information : 'O' = Direct Observation : 'I' = Interview</font></td>
		</tr>
		<tr>
			<td>
			<table border="0" width="100%" id="table12" cellpadding="0">
				<tr>
					<td width="58" align="center" height="29" bgcolor="#F7E6B7">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					S. No.</font></td>
					<td width="518" height="29" bgcolor="#F7E6B7">
					<p align="center">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					Question</font></td>
					<td height="29" bgcolor="#F7E6B7">
					<p align="center">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					Type</font></td>
					<td width="133" height="29" bgcolor="#F7E6B7">
					<p align="center">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					Yes / No</font></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					1</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is there a latrine within 10 meteres of the Handpump / Well</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q1"><?php echo "$row2[type_q1]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q1"><?php echo "$row2[risk_analysis_q1]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					2</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is there a Cattle water Trough (CWT) near the Handpump / 
					Well / GLR</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q2"><?php echo "$row2[type_q2]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
						<label id="risk_analysis_q2"><?php echo "$row2[risk_analysis_q2]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					3</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Other than Latrines and Domestic animals, are there any 
					other sources of pollutions with ten meters of borehole? 
					(i.e. excreta, garbage, drains / channels, sewers, ponds, 
					dugwells, cultivation)</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q3"><?php echo "$row2[type_q3]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
						<label id="risk_analysis_q3"><?php echo "$row2[risk_analysis_q3]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					4</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is there drain/ channel/ water logging / Pond nearby the GLR 
					/ Stand Post / P &amp; T</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q4"><?php echo "$row2[type_q4]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q4"><?php echo "$row2[risk_analysis_q4]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					5</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is the well parapet (wall) missing, damaged or less the 
					0.75m above the ground level.</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q5"><?php echo "$row2[type_q5]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q5"><?php echo "$row2[risk_analysis_q5]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					6</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Does the inner seal (i.e. lining) around the top of the well 
					extend less then 1.0 meter wide?&nbsp;&nbsp; </font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q6"><?php echo "$row2[type_q6]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q6"><?php echo "$row2[risk_analysis_q6]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					7</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is the Apron around the prapet&nbsp; missing, damaged, or 
					less then 1.0 meters wide.</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q7"><?php echo "$row2[type_q7]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q7"><?php echo "$row2[risk_analysis_q7]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					8</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is water withdrawn by rope and bucket, or windlass rather 
					then a pump?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q8"><?php echo "$row2[type_q8]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q8"><?php echo "$row2[risk_analysis_q8]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					9</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is the discharge channel missing , damaged or blocked with 
					debris?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q9"><?php echo "$row2[type_q9]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q9"><?php echo "$row2[risk_analysis_q9]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					10</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Can waste water or rain water collect within 3 meters of the 
					well/ or borewell ?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q10"><?php echo "$row2[type_q10]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q10"><?php echo "$row2[risk_analysis_q10]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					11</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Can water, dirt or dust enter the well/borewell at the point 
					of attachment of handpump?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q11"><?php echo "$row2[type_q11]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q11"><?php echo "$row2[risk_analysis_q11]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					12</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Is apron missing, damaged or less than 1.85 m in diameter ?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q12"><?php echo "$row2[type_q12]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q12"><?php echo "$row2[risk_analysis_q12]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					13</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					can waste water collect on apron ?</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q13"><?php echo "$row2[type_q13]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q13"><?php echo "$row2[risk_analysis_q13]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					14</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Do people regularly bath, and wash closth or cooking/ eating 
					uthnsils at the hand pump/GLR</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q14"><?php echo "$row2[type_q14]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q14"><?php echo "$row2[risk_analysis_q14]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					15</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Are villagers satisfied with PHED supply </font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q15"><?php echo "$row2[type_q15]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q15"><?php echo "$row2[risk_analysis_q15]";?></label></td>
				</tr>
				<tr>
					<td width="58" align="center" bgcolor="#FDF9EE">
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					16</font></td>
					<td width="518" bgcolor="#FDF9EE">
					<font face="Verdana" style="font-size: 8.5pt" color="#000000">
					Are there pvt TWs/OWs used by villagers for drinking water 
					supply</font></td>
					<td bgcolor="#FDF9EE" align="center">
					<label id="type_q16"><?php echo "$row2[type_q16]";?></label></td>
					<td width="133" bgcolor="#FDF9EE" align="center">
					<label id="risk_analysis_q16"><?php echo "$row2[risk_analysis_q16]";?></label></td>
				</tr>
			</table>
			</td>
		</tr>
		<tr>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>&nbsp;
			</td>
		</tr>
		<tr>
			<td bgcolor="#EEEEEE" height="20">
			<font face="Arial" color="#000000">
			<span style="font-size: 8.5pt; font-weight: 700">&nbsp;
			<span style="font-weight: 700; font-size:8.5pt">
			<font style="font-size: 8.5pt; font-weight:700"></font></span>Result 
			and Recommendations </span></font></td>
		</tr>
		<tr>
			<td>
			<table border="0" width="100%" id="table13" cellspacing="0" height="74">
				<tr>
					<td bgcolor="#F7E6B7">&nbsp;<font style="font-size: 8.5pt" face="Verdana" color="#000000">&nbsp; 
					The following important points of risk were noted</font></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE" align="center"><label id="imp_points_risk"><?php echo "$row2[imp_points_risk]";?></label></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE">&nbsp;</td>
				</tr>
				<tr>
					<td bgcolor="#F7E6B7">&nbsp;
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					N<font style="font-size: 8.5pt">ame of th</font>e Assessor
					</font></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE" align="center"><label id="name_assessor"><?php echo "$row2[name_assessor]";?></label></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE">&nbsp;</td>
				</tr>
				<tr>
					<td bgcolor="#F7E6B7">&nbsp;
					<font style="font-size: 8.5pt" face="Verdana" color="#000000">
					N<font style="font-size: 8.5pt">ame of th</font>e Key 
					Contact</font></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE" align="center"><label id="name_key_contact"><?php echo "$row2[name_key_contact]";?></label></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE">&nbsp;</td>
				</tr>
				<tr>
					<td bgcolor="#F7E6B7">&nbsp;<font style="font-size: 8.5pt" face="Verdana" color="#000000"> 
					Contact Details&nbsp; </font></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE" align="center"><label id="contact_details"><?php echo "$row2[contact_details]";?></label></td>
				</tr>
				<tr>
					<td bgcolor="#FDF9EE">&nbsp;</td>
				</tr>
			</table>
			</td>
		</tr>
		<tr>
			<td>
			<table border="0" width="100%" id="table11" cellspacing="0" cellpadding="0">
				<tr>
					<td>&nbsp;</td>
				</tr>
			</table>
			</td>
		</tr>
		<tr>
			<td>&nbsp;
			</td>
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			<td>&nbsp;</td>
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